4 1/2 Ways to Pay

Copyright © 2011, Douglas D. Germann, Sr., Professional Corporation.
574/291-0022, fax 574/291-0024, PO Box 2796, South Bend, IN 46680-2796

In the US today, you have available to you only 4½ ways to pay for Long-Term Care, whether in a nursing home, assisted living facility, or at home.

½. Veteran’s Administration. The reason I rate this a half is that the largest Aid and Attendance “pension” available to help with Long-Term Care is about $1,900 per month. This would pay for about half the cost of an assisted living facility, and a quarter of the cost of a nursing home. So you need other income to help you, and your costs need to be low. Plus you have to be a war-time veteran with the right kind of a discharge.

1. A daughter or daughter-in-law. Yes, statistically this is gender-specific. Much of the care, probably most of the care, provided to the elderly in this country is provided by a family member; often she will quit her career to care for you. If all the daughters and daughters-in-law in this country went on strike from providing elder care, the system would grind to a halt.
2. Your own pocket. With costs in north central Indiana currently running about $8,000 per month ($96,000 per year), you can run through a decent lifetime savings in a few years or months.
3. Long-Term Care insurance. This is available to you up to about age 80, while you are still healthy. There are regular policies and state qualified partnership policies. If your policy is more than a couple years old, you should have it reviewed: you might be able to do better. The premiums, once you get above 65 or so, are take-your-breath-away, but nowhere near $8,000 per month. I recommend this as your first choice: you are taking the responsibility to provide your own care.
4. Medicaid. Medicaid is a combined state and federal program which provides Long-Term care for middle to low-income people. Here is another way to think about Medicaid. About two-thirds of all residents of Indiana nursing homes are on Medicaid. You must qualify to get Medicaid: your assets must be below $1,500, and generally you cannot give away your property within 60 months of your application. There are things to do to protect the at-home spouse, and it is possible to protect many more assets than the $1,500 so you can have a better quality of care. But the rules are changing faster than even the Federal Tax Code, so you need competent legal counsel: what worked for your aunt last year might not work for you now.

Douglas D. Germann, Sr., Professional Corporation P.O. Box 2796, South Bend, IN 46680-2796 telephone 574/291-0022; fax 574/291-0024 email [email protected]